How healthcare providers' IT identity is formed and how it affects the use of telemonitoring: a qualitative interview study in COPD care

BACKGROUND: Telemonitoring is a promising approach to facilitate patients' self-management and improve health outcomes, especially among people with chronic health conditions. Yet, many healthcare organisations struggle to implement telemonitoring successfully. IT identity, an individual's self-identification with an information technology (IT) tool, has been suggested to strongly predict and shape the use of technology. IT identity is related to three emotional responses: emotional energy, dependence and relatedness.

OBJECTIVE: To explore how healthcare professionals' IT identity is shaped, and how it affects their attitude towards and intended use of telemonitoring.

DESIGN: Qualitative, semistructured interview study.

SETTING: Primary care and hospitals (general and academic) in the Netherlands.

PARTICIPANTS: Sixteen nurses, pulmonologists, general practitioners and researchers working in chronic obstructive pulmonary disease (COPD) care.

RESULTS: Participants expressed varying emotional responses regarding the use of telemonitoring. We associated participants' responses with the three dimensions of IT identity. Regarding emotional energy, some expressed pride in innovating, while others lacked faith in using telemonitoring. Regarding dependence, different perceived intentions and needs for using telemonitoring were identified: to coach patients, prevent deterioration of health, achieve logistical advantages for patients and preserve the accessibility of healthcare. Regarding relatedness, some participants expressed a strong external but weak internal motivation to use telemonitoring.Based on emotional responses, we identified five manifestations of IT identity that illustrate how different healthcare professionals use telemonitoring in COPD care: the Scientist, Innovator, Protector, Empowerer and Conversationalist. These manifestations differ in their readiness to innovate and in their beliefs what it means to be a good healthcare provider: to protect or to coach.

CONCLUSION: Healthcare professionals' emotional energy, dependence and relatedness regarding telemonitoring in COPD care shaped their IT identity and how they used telemonitoring. Implementation strategies tailored towards the five manifestations of IT identity could help the sustainable implementation of telemonitoring in clinical practice.